Current State
• 366% increase in overdose deaths in the
U.S. between 2000 to 2012
• Most overdose deaths were from
prescription meds until 2012
• Significant shift from prescription meds
to heroin related deaths in 2012
Why the shift to heroin?
• Growing opiate addicted population
• Shutdown of southern Ohio pill mills
• Ohio Emergency & Acute Care Facility
Opioid and other Controlled Substances
Prescribing Guidelines
• Tamper resistant long-acting opioid
formulations
• Increased supply of pure, cheap heroin
Death rates are increasing in the younger
population
• Males 25-34 are at highest risk for heroin
deaths
• Treatment admissions show that ALL
demographics are increasingly reporting
heroin as their primary drug
Butler County
• 56 = Heroin related deaths in the first six
months of 2014
• 85 = Heroin related deaths in the first six
months of 2015
• 103 = Heroin related deaths in 2014
• 149 = Heroin related deaths in 2015
In 2014, overdose deaths surpassed
deaths due to natural causes for the first
time in recorded history.
Warren County
• In 2013 and 2014, unintentional overdose
deaths rose by 50% each year.
• Warren County Coroner no longer performs
autopsies on suspected overdose victims due to
the high volume of overdose deaths.
How Does Heroin Impact the
Community?
• Increased crime and use of law
enforcement resources
• Increased use of EMS
• Increased use of healthcare resources
• Financial burden on community
• “Unseen” costs to the community
Impact on Law Enforcement
• In 2014, the Middletown Division of Police
spent $1.2 million investigating 1500
heroin complaints resulting in:
– 66 Search Warrants
– 2 Murders
– 86 Deaths
– 700 Arrests for Drug Related Crimes
Increase in Drug-Related Ancillary Crime
– In 2014 Middletown Police Officers responded
to more than 200 thefts, almost 100
robberies, over 900 burglaries, and multiple
prostitution calls related to supporting the
drug addicts’ habit.
– MPD Officers spent over 3,000 man hours
responding to drug crimes along with
additional hours spent testifying in court
• Delay in response times
• Increase in violent crime
Butler and Warren Counties are both
identified by the Federal Government
and the DEA to be HIDTA – High Intensity
Drug Trafficking Areas.
– I-75 and I-71 frequently used
– Attracts high-level drug traffickers
• Increase of motor vehicle accidents due
to driving under the influence of opiates
and pursuits.
Impact on EMS
• In 2014 the Middletown Division of Fire spent over
$175,000 responding to 702 reported overdoses within
the city limits.
• Middletown paramedics administered Narcan 333 times
in 2014.
• Increased risk of needlesticks, blood exposures, and
assault to EMS.
– Patients often extremely combative after receiving
Naloxone.
– Overdose scenes often present a high risk to EMS due
to bystanders who are afraid of criminal charges.